Creating the Next Generation of Translational Geroscientists

Abstract

Advances in understanding fundamental processes of aging have led to a variety of investigational therapies to delay or prevent age-related diseases and conditions. These geroscience therapeutics hold the promise of revolutionizing medical care of older adults by treating the complex syndromes of aging and preserving health and independence. A crucial bottleneck is the study of geroscience therapeutics in early-stage, first-in-human, or proof-of-concept clinical trials. There is a limited pool of clinical investigators with the combination of knowledge and skills at the interface of clinical research, care of older adults, and aging biology needed to successfully design, fund, and implement geroscience trials. Current training pipelines are insufficient to meet the need. The sixth retreat of the National Institute on Aging R24 Geroscience Network brought together basic scientists, gerontologists, clinicians, and clinical researchers from the United States and Europe to discuss how to identify, recruit, and train investigators who can perform early-stage clinical trials in geroscience. We present herein the group's consensus on necessary subject domains and competencies, identification of candidate learners, credentialing learners, and the efficient and rapid implementation of training programs. Foundations and funding agencies have crucial roles to play in catalyzing the development of these programs. Geriatrician investigators are indispensable but cannot meet the need alone. Translational geroscience training programs can create a cadre of groundbreaking investigators from a variety of backgrounds and foster institutional cultures supportive of multidisciplinary translational aging research to turn innovative ideas into transformative therapeutics that can improve the health and independence of older adults. J Am Geriatr Soc 67:1934-1939, 2019.

Figure 1

What is translational geroscience? A deep understanding of fundamental mechanisms of aging leads to the development of therapeutic interventions. These aging‐targeting interventions are then tested for efficacy in clinical trials using outcomes that broadly represent aging, including geriatric syndromes, chronic diseases of aging and multimorbidity, or decreased physical resilience. The first generation of such geroscience clinical trials is currently underway or completed. Mechanisms of aging are adapted from the “Pillars of Aging”,1 and clinical trial frameworks are from an earlier report of the Geroscience Network.7

Figure 2

Translational geroscience research comprises four content domains: general clinical research, geriatric medicine, geriatric clinical research, and geroscience. Representative core competencies within each content domain are displayed. A complete list of competencies is under development. CTSA, Clinical and Translational Science Award program; IND, Investigational New Drug; PoC, Proof of Concept.